The use of 3D computer-assisted navigation and its influence on radiation exposure in the surgical treatment of fragility fractures of the pelvis

Introduction

Fragility fractures of the pelvis (FFP) are increasing among the elderly. These injuries significantly impact morbidity and mortality, necessitating advanced treatment approaches. Operating rooms, equipped with 3D computer-assisted navigation are more frequently used in the treatment of FFP. This study aims to compare radiation exposure and surgical outcomes for the treatment of fragility fractures of the pelvis (FFP) with or without 3D computer-assisted navigation.

Methods

This retrospective study included 36 patients treated surgically for FFP between 1st of January 2017, and 26th of May 2023. Patients were divided into two groups: those treated with conventional fluoroscopy (2D-CF) (n=18) and those with 3D computer-assisted navigation (3D-CAN) (n=18). Data on demographics, ASA scores, fracture types and operative parameters were collected. The primary outcome was intraoperative fluoroscopy time. Secondary outcomes included operation time and complications. Statistical analysis was conducted with SPSS, with statistical significance determined at p<0.05.

Results

Eighteen patients were included in both groups. There were no significant differences in baseline patient characteristics between the groups. 3D-CAN showed a significant reduction in fluoroscopy time (78.4 ± 33.7 seconds) compared to 2D-CF (190.3 ± 86.9 seconds, p=0.000). The mean operative time was also significantly lower in 3D-CAN (62.1 ± 18.3 minutes) compared to 2D-CF (85.0 ± 28.1 minutes, p=0.007). In 3D-CAN fewer screw-related complications were observed.

Conclusion

Hybrid operating rooms with 3D computer-assisted navigation systems significantly reduce patient radiation exposure and operative time in the surgical treatment of pelvic fragility fractures.

Björn-Christian Link is a Siemens consultant

The University of Luzern provides funds to Roelien Haveman